The long term goal of this project is improvement in the quality of acupuncture treatment. This will be accomplished by developing a tool (the Acusensor) capable of tracking acupuncture needle movement and force interactions. The Acusensor will be applied immediately to improve acupuncture training and research, which will lead to improvements in clinical practice. Our specific aims include: 1) Improve the Acusensor prototype which currently measures needle torque, to additionally measure angular displacement (degrees of rotation), axial displacement (amount of up and down movement), and axial force. 2) Develop a user-friendly software interface displaying Acusensor data in a visual real-time format. This will enable users to instantly view needling profiles oriented to needle motion or tissue force response. 3) The Acusensor will be used to characterize types (e.g. tonifying, dispersing) and styles (e.g. Japanese, Chinese) of needle manipulation. By objectively characterizing needling manipulation techniques, researchers will be able to design future clinical trials which can answer important questions that have thus far remained untested (e.g. - Was the intended manipulation successfully replicated throughout the trial? Are certain manipulations more effective than others for specific clinical conditions?). 4) The Acusensor will be used to teach needle manipulation. Acupuncture students will use the Acusensor to enhance their ability to accurately and reliably reproduce target manipulations demonstrated by their instructors. Needling technique is a notoriously difficult skill to master. This is compounded by the lack of tools with which to evaluate needling activity. By providing profiles of needling via a real-time graphic interface, this technology will potentially transform the teaching of needling techniques. This technology will allow users, for the first time, to test assumptions and improve practices related to a fundamental component of acupuncture} needling. It will provide a needed tool to acupuncture researchers, educators and clinicians which will ultimately be translated into improvements in the quality of acupuncture treatments for the benefit of patients. PUBLIC HEALTH RELEVANCE: Acupuncture has been used by an estimated 8.2 million US adults - 2.1 million in 2001 alone. Acupuncture needling techniques vary widely and are difficult to replicate. Efforts to evaluate acupuncture needling have been hampered by a lack of objective measurement tools. The new Acusensor technology will provide a needed tool to identify best practices related to acupuncture needling. Data gathered by this tool will be translated into improvements in the quality of acupuncture treatments for the benefit of patients.